甲状腺良性肿瘤经胸乳入路腔镜切除术与开放性手术Meta分析

目的 探讨胸乳入路腔镜甲状腺切除术与开放甲状腺切除术治疗良性甲状腺肿瘤的安全性及效果。 方法 对2015年1月1日至2018年12月31日，国内期刊发表的胸乳入路腔镜甲状腺切除术与开放甲状腺切除术在治疗良性甲状腺肿瘤方面的文章进行Meta分析。 结果 最终纳入13篇文献，累计腔镜组702例，开放组854例。腔镜组手术时间长于开放组（MD=448，95％CI：300～597，P＜005），术中出血量少于开放组（MD=-2270，95％CI：-2340～-2201，P＜005），术后住院时间少于开放组（MD=-238，95％CI：-249～-228，P＜005），术后引流量少于开放组（MD=-532，95％CI：-601～-463，P＜005），术后并发症发生率少于开放组（OR=031，95％CI：021～048，P＜005），住院费用多于开放组（MD=1 49765，95％CI：1 40386～1 59144，P＜005）。 结论 经胸乳入路腔镜手术是一种安全可靠的手术方式，具有创伤小、恢复快、术后并发症少等优势，且美容效果好，是甲状腺良性肿瘤手术的理想入路选择。

Meta-analysis of transthoracic thyroid surgery versus open surgery for the clinical effects of benign thyroid tumors

Objective: To evaluate the safety and therapeutic effect of transthoracic laparoscopic thyroidectomy by meta-analysis of breast-assisted laparoscopic thyroid surgery and open surgery for benign thyroid tumors. METHODS: case-control studies published by domestic scholars on the comparison of laparoscopic thyroid surgery versus traditional open surgery in the treatment of benign thyroid tumors were collected in 2015-2018,then were comprehensively analyzed by meta-analysis.RESULTS: A total of 602 patients in the laparoscopic group and 754 patients in the open group were included. The following results were obtained: operative time of laparoscopic group is longer than open group (MD = 4.48, 95% CI: 3.00-5.97, P < 0.05). The volume of intraoperative blood loss of the laparoscopic group is less than the open group (MD = -22.70, 95% CI: -23.40 to -22.01, P < 0.05), postoperative hospital stay of laparoscopic group was short than the open group (MD = -2.38). , 95% CI: -2.49 - 2.28, P < 0.05), The volume of postoperative drainage of laparoscopic group is less than the open group (MD = -5.32, 95% CI: -6.01 ~ -4.63, P < 0.05), The incidence of postoperative complications of the laparoscopic group less than the open group (OR = 0.31, 95% CI: 0.21 to 0.48, P < 0.05), hospitalization costs of the laparoscopic group was more than the open group (MD = 1497.65, 95% CI: 1403.86 ~ 1591.44, P < 0.05). Conclusion: The endoscopic thyroidectomy via breast approach surgery is safe and reliable . It has the advantages of small trauma、 quick recovery、 less postoperative complications and cosmetic effects. It is an ideal choice for benign thyroid tumor surgery and be worthy of clinical promotion to patients with better economic conditions